Anti-Infective – Sulfonamides

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Outline

Overview

  1.        Overview

A.    Bacteriostatic agents

B.    Gram + / – organisms

C.     Types

1.     Sulfonamides

2.     Sulfisoxazole

3.     Sulfamethizole

4.     Sulfasalazine

5.     Trimethoprim / Sulfamethoxazole (TMP/SMX)

6.     Sulfadoxine / Pyrimethamine

7.     Silver Sulfadiazine

8.     Sulfanilamide

9.     Sulfacetamide

     II.         II. Mechanism of Action

A.    Preventing bacterial synthesis of folic acid

   III.         III. Indications

A.    Plasmodium and Toxoplasma spp

B.    Inflammatory bowel disease 

C.     Nocardiosis

D.    Urinary tract infections

E.     Malaria

F.     Burns

G.    Vaginitis

H.    Ocular infections

   IV.         IV. Contraindications

A.    Drug allergy

B.    Porphyria

C.     Pregnant women 

D.    Infants

    V.         V. Interactions

A.    Sulfonylureas

B.    Phenytoin

C.     Warfarin

D.    Cyclosporine

   VI.         VI. Side Effects

A.    Hematological

1.     Agranulocytosis

2.     Aplastic anemia

3.     Hemolytic anemia

4.     Thrombocytopenia

B.    Gastrointestinal

1.     Nausea

2.     Vomiting

3.     Diarrhea

4.     Pancreatitis

C.     Integumentary

1.     Epidermal necrolysis

2.     Exfoliative dermatitis

3.     Stevens-Johnson syndrome

4.     Photosensitivity

D.    Other

1.     Convulsions

2.     Crystalluria

3.     Toxic nephrosis

4.     Headache

5.     Peripheral neuritis

6.     Urticaria

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Transcript

Hey there, and today’s we are going to discuss sulfonamides, which are a certain type of antibiotic class.

Alright, quick overview. sulfonamides are bacteriostatic, meaning they stop bacteria from reproducing, while not necessarily killing them. The mechanism of action that causes these antibiotics to work is related to their ability to prevent the synthesis of folic acid – which is needed for cell growth. Sulfonamides are used to treat gram +/- organisms.

Sulfonamides all begin with SULF-, which is an easy way to remember this drug class.

Sulfonamides indications can be remembered as PINUMOBV, plasmodium / toxoplasma (parasites), IBD, nocardosis, UTI, malaria, ocular infections, burns and vaginitis.

Sulfonamides contraindications can be remembered by DIPP – drug allergy, infants (hyperbilirubinemia in neonates may cause kernicterus, porphyria – abnormalities in the chemical steps that lead to heme production), and pregnant women (as these drugs can cause birth defects).

Sulfonamides interactions include sulfonylurea, phenytoin, warfarin and cyclosporine. Interactions with warfarin cause increase in warfarin effects (SPWC).


Sulfonamides side effects are broken into four categories. The first one is hematologic and include – agranulocytosis, aplastic anemia, hemolytic anemia and thrombocytopenia.

The second category is GI and include N/V/D and pancreatitis.

The third category is integumentary and includes epidermal necrolysis (which is widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes, resulting in exfoliation and possible sepsis), exfoliative dermatitis, Stevens-Johnson syndrome (severe skin reaction) and photosensitivity.

The fourth and final category is other and includes – Convulsions, crystalluria, toxic nephrosis, headache, peripheral neuritis and urticaria.

Priority nursing concepts for sulfonamides include pharmacology and infection control.

Alright, let’s review, sulfonamides being with SULF-. Indications include plasmodium / toxoplasma (parasites), IBD, nocardosis, UTI, malaria, ocular infections, burns and vaginitis (PINUMOBV). Contraindications include drug allergy, infants, porphyria (POUR-FEAR-IA) and pregnant women (DIPP). Interactions include sulfonylurea, phenytoin, warfarin and cyclosporine (SPWC). Side effects are broken down into four categories – heme (agranulocytosis, aplastic anemia, hemolytic anemia and thrombocytopenia) / GI (and include N/V/D and pancreatitis) / integumentary (epidermal necrolysis, exfoliative dermatitis, Stevens-Johnson syndrome and photosensitivity / other (convulsions, crystalluria, toxic nephrosis, headache, peripheral neuritis and urticaria).

You know now the important details regarding sulfonamides. Now, go out and be your best self today and as always, Happy Nursing!

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DRN 201, Week 9

Concepts Covered:

  • Disorders of Pancreas
  • Endocrine
  • Renal
  • Newborn Care
  • Renal Disorders
  • Pregnancy Risks
  • Medication Administration
  • Respiratory Disorders
  • Female Reproductive Disorders
  • Male Reproductive Disorders
  • Integumentary Disorders
  • Musculoskeletal Trauma
  • Urinary System
  • Immunological Disorders
  • Acute & Chronic Renal Disorders
  • Emergency Care of the Neurological Patient

Study Plan Lessons

03.04 DKA vs HHNK for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
Antidiabetic Agents
Blood Glucose Monitoring
Creatinine Clearance Lab Values
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Diabetes Mellitus & Those Dang Blood Sugars! – Live Tutoring Archive
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetic Emergencies for Certified Emergency Nursing (CEN)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Gestational Diabetes (GDM)
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Glipizide (Glucotrol) Nursing Considerations
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Hemoglobin A1c (HbA1C)
Insulin
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Case Study for Type 1 Diabetes
Anti-Infective – Sulfonamides
Wounds (Infectious, Surgical, Trauma) for Progressive Care Certified Nurse (PCCN)
Insulin Mnemonic (Ready, Set, Inject, Love)
Amputation
Nursing Case Study for Diabetic Foot Ulcer
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)
Gabapentin (Neurontin) Nursing Considerations
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
03.03 Hypoglycemia for CCRN Review
Acute Confusion
Corticosteroids
Glucagon Lab Values
Glucagon (GlucaGen) Nursing Considerations
Hyperglycemia for Progressive Care Certified Nurse (PCCN)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)